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Children and COVID-19 Research Library

UNICEF Innocenti's curated library of COVID-19 + Children research

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31 - 45 of 49
The effect of COVID-19 on maternal newborn and child health (MNCH) services in Bangladesh, Nigeria and South Africa: call for a contextualised pandemic response in LMICs

AUTHOR(S)
Tanvir Ahmed; Ahmed Ehsanur Rahman; Taiwo Gboluwaga Amole (et al.)

Published: March 2021   Journal: International Journal for Equity in Health
Global response to COVID-19 pandemic has inadvertently undermined the achievement of existing public health priorities and largely overlooked local context. Recent evidence suggests that this will cause additional maternal and childhood mortality and morbidity especially in low- and middle-income countries (LMICs). This paper has explored the contextual factors influencing maternal, neonatal and children health (MNCH) care in Bangladesh, Nigeria and South Africa amidst the pandemic.
COVID-19 and the Looming Debt Crisis: Protecting and Transforming Social Spending for Inclusive Recoveries

Compounding the COVID-19 pandemic is a looming debt crisis for low- and middle-income countries where a growing debt burden threatens to crowd out social spending for children.

This policy brief explores whether the current support from the international community is enough to maintain spending on basic services during COVID-19. It highlights countries that are most at risk due to high levels of poverty, as well as those less likely to benefit from the G20 Debt Standstill (DSSI). It concludes that a new international debt restructuring architecture, which encompasses the needs of poorer countries, is crucial to protecting children’s rights in the wake of COVID-19. 

Revisiting maternal and child undernutrition in low-income and middle-income countries: variable progress towards an unfinished agenda

AUTHOR(S)
Cesar G. Victora; Parul Christian; Luis Paulo Vidaletti (et al.)

Published: March 2021   Journal: The Lancet
13 years after the first Lancet Series on maternal and child undernutrition, we reviewed the progress achieved on the basis of global estimates and new analyses of 50 low-income and middle-income countries with national surveys from around 2000 and 2015. The prevalence of childhood stunting has fallen, and linear growth faltering in early life has become less pronounced over time, markedly in middle-income countries but less so in low-income countries. Stunting and wasting remain public health problems in low-income countries, where 4·7% of children are simultaneously affected by both, a condition associated with a 4·8-times increase in mortality. New evidence shows that stunting and wasting might already be present at birth, and that the incidence of both conditions peaks in the first 6 months of life. Global low birthweight prevalence declined slowly at about 1·0% a year. Knowledge has accumulated on the short-term and long-term consequences of child undernutrition and on its adverse effect on adult human capital. Existing data on vitamin A deficiency among children suggest persisting high prevalence in Africa and south Asia. Zinc deficiency affects close to half of all children in the few countries with data. New evidence on the causes of poor growth points towards subclinical inflammation and environmental enteric dysfunction. Among women of reproductive age, the prevalence of low body-mass index has been reduced by half in middle-income countries, but trends in short stature prevalence are less evident. Both conditions are associated with poor outcomes for mothers and their children, whereas data on gestational weight gain are scarce. Data on the micronutrient status of women are conspicuously scarce, which constitutes an unacceptable data gap. Prevalence of anaemia in women remains high and unabated in many countries. Social inequalities are evident for many forms of undernutrition in women and children, suggesting a key role for poverty and low education, and reinforcing the need for multisectoral actions to accelerate progress. Despite little progress in some areas, maternal and child undernutrition remains a major global health concern, particularly as improvements since 2000 might be offset by the COVID-19 pandemic.
COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health

AUTHOR(S)
Lola Kola; Brandon A. Kohr; Charlotte Hanlon (et al.)

Published: February 2021   Journal: The Lancet Psychiatry
Most of the global population live in low-income and middle-income countries (LMICs), which have historically received a small fraction of global resources for mental health. The COVID-19 pandemic has spread rapidly in many of these countries. This Review examines the mental health implications of the COVID-19 pandemic in LMICs in four parts. First, it reviews the emerging literature on the impact of the pandemic on mental health, which shows high rates of psychological distress and early warning signs of an increase in mental health disorders. Second, it assesses the responses in different countries, noting the swift and diverse responses to address mental health in some countries, particularly through the development of national COVID-19 response plans for mental health services, implementation of WHO guidance, and deployment of digital platforms, signifying a welcome recognition of the salience of mental health. Third, it considers the opportunity that the pandemic presents to reimagine global mental health, especially through shifting the balance of power from high-income countries to LMICs and from narrow biomedical approaches to community-oriented psychosocial perspectives, in setting priorities for interventions and research. Finally, this study presents a vision for the concept of building back better the mental health systems in LMICs with a focus on key strategies; notably, fully integrating mental health in plans for universal health coverage, enhancing access to psychosocial interventions through task sharing, leveraging digital technologies for various mental health tasks, eliminating coercion in mental health care, and addressing the needs of neglected populations, such as children and people with substance use disorders.
Assessment of midwifery care providers intrapartum care competencies, in four sub-Saharan countries: a mixed-method study protocol

AUTHOR(S)
Ann‑Beth Moller; Joanne Welsh; Mechthild M. Gross (et al.)

Published: February 2021   Journal: Reproductive Health
This study aims to assess competencies (knowledge, skills and attitudes) of midwifery care providers as well as their experiences and perceptions of in-service training in the four study countries; Benin, Malawi, Tanzania and Uganda as part of the Action Leveraging Evidence to Reduce perinatal mortality and morbidity in sub-Saharan Africa project (ALERT). While today more women in low- and middle-income countries give birth in health care facilities, reductions in maternal and neonatal mortality have been less than expected. This paradox may be explained by the standard and quality of intrapartum care provision which depends on several factors such as health workforce capacity and the readiness of the health system as well as access to care.
Through their eyes: exploring the complex drivers of child marriage in humanitarian contexts

AUTHOR(S)
Elizabeth Presler-Marshall; Nicola Jones; Sarah Alheiwidi

Institution: Gender and Adolescence Global Evidence
Published: December 2020
Child marriage, while declining in most parts of the world, remains common in many communities – especially in countries beset by conflict and other humanitarian disasters. Indeed, all 10 of the countries with the highest rates of child marriage are considered fragile, and research has found that child marriage is one of the issues most sensitive to conflict. A growing body of evidence underscores that this is because although the drivers of child marriage tend to be similar across development and humanitarian contexts – and revolve around physical and economic insecurities and deep-seated gender norms – fragility, conflict and disaster augment concerns and can increase the risk of child marriage. This report begins with a brief overview of the evidence base. It then describes the sample and methodological approach used by Gender and Adolescence: Global Evidence (GAGE) to explore the drivers of child marriage in humanitarian settings and how tailored policy and programming might be brought to bear to reduce it.
The changing aspects of motherhood in face of the COVID-19 pandemic in low- and middle-income countries

AUTHOR(S)
Jennifer Prince Kingsley; Paul Kingsley Vijay; Jacob Kumaresan (et al.)

Published: November 2020   Journal: Maternal and Child Health Journal
The aim of this article is to advocate perspectives to strengthen existing healthcare systems to prioritize maternal health services amidst and beyond the COVID-19 pandemic in low- and middle income countries. COVID-19 directly affects pregnant women causing more severe disease and adverse pregnancy outcomes. The indirect effects due to the monumental COVID-19 response are much worse, increasing maternal and neonatal mortality.
Intersecting vulnerabilities: the impacts of COVID-19 on the psycho-emotional lives of young people in low- and middle-income countries

AUTHOR(S)
Prerna Banati; Nicola Jones; Sally Youssef

Published: November 2020   Journal: The European Journal of Development Research
Across diverse contexts, emerging evidence suggests that the COVID-19 pandemic is increasing levels of anxiety and stress. In calling for greater attention to people’s psychosocial and emotional well-being, global actors have paid insufcient attention to the realities of the pandemic in low- and middle-income countries, where millions of people are already exposed to intersecting vulnerabilities. Chronic poverty, protracted violence, confict and displacement, coupled with weak health, education and protection systems, provide the backdrop of many adolescents’ lives. Drawing on qualitative in-country telephone interviews with over 500 adolescents in Ethiopia, Côte d’Ivoire and Lebanon, this article unpacks the age and gendered dimensions of COVID-19 and its response.
Close to contagion: the impact of COVID-19 on displaced and refugee girls and women
Institution: Plan International
Published: September 2020

Currently, as COVID-19 spreads across the world, an unprecedented 76.7 million people are living as refugees, or have been displaced inside their countries. Some 131 of the countries affected by COVID-19 have sizeable refugee populations and more than 80% of refugees are hosted in low- and middle-income countries including Uganda, Sudan, Pakistan and Turkey, with health systems that are ill-equipped to manage significant outbreaks. Refugee and IDP camps are mostly chronically overcrowded and measures to avoid community transmission of the virus, such as physical distancing and frequent handwashing, are difficult to implement. The absence of basic amenities, such as clean running water and soap, insufficient medical personnel, and poor access to health information, let alone access to masks, will make avoiding infection virtually impossible. Also, in many host countries, refugees’ entitlement to healthcare and social protection systems are restricted or non-existent, which increases their vulnerability even further.

‘I have nothing to feed my family…’: covid-19 risk pathways for adolescent girls in low- and middle-income countries

AUTHOR(S)
Nicola Jones; Agnieszka Małachowska; Silvia Guglielmi (et al.)

Institution: Gender and Adolescence Global Evidence
Published: August 2020

Unlike the H1N1 influenza virus, to which younger people were relatively more susceptible, and Ebola, where adolescents were at greater risk than younger children but at lower risk than the most-affected age group (35–44 years), the demographic burden of covid-19 is highly skewed towards older persons aged 70 and over. Age-disaggregated statistics suggest that adolescents are least likely to be hospitalised and to die from covid-19. Young people have typically been portrayed in the mainstream media as ‘part of the problem’ – as both vectors of the disease and as reluctant to adopt preventive measures, rather than as key actors to be proactively included in the emergency and recovery responses.  As the spike in unemployment and predictions of global recession underline, Covid-19 is not only an unprecedented health crisis but also a profound economic and social one. This is the first in a series of briefs. It focuses on the short-term effects of covid-19 and associated lockdowns on adolescent girls and boys in LMICs. The next brief will focus on the effects of the pandemic six months after lockdowns.

Are child and youth population at lower risk of COVID-19 fatalities? Evidences from South-East Asian and European countries

AUTHOR(S)
Ankita Zaveri; Pradip Chouhan

Published: August 2020   Journal: Children and Youth Services Review

The coronavirus disease (COVID-19) pandemic has revealed many lacunas of public health preparedness, especially in lower and middle-income countries and fatality differentials between European and South-East Asian countries. The case fatality rate (CFR) in most of the South-East Asian countries is much lower than the European countries. The percentages of child and youth population are more in South-East countries. The study aims to show the impacts of age composition on fatality differentials in European and South-East Asian countries by age-structure, especially the percentage share of child and youth population.

The emerging lessons on urban vulnerability and safety from Covid-19 in low- and middle-income countries

AUTHOR(S)
Jaideep Gupte

Institution: Institute of Development Studies, UN Habitat
Published: July 2020
This discussion paper sets forth the lessons on urban vulnerability and safety, relevant to the security sector, emerging from coronavirus (Covid-19) and its related socioeconomic impacts on urban societies in low- and middle-income countries.
Prioritising children's rights in the COVID-19 response
Institution: The Lancet
Published: July 2020   Journal: The Lancet Child & Adolescent Health
Although substantial progress has been made in many aspects of child health in the past two decades, the COVID-19 pandemic and its wide-ranging effects are threatening some of these hard-won gains. Public health measures such as lockdown, school closures, and restrictions in population movement—while necessary to halt virus transmission—are causing prolonged disruption to societal functioning and exacerbating inequalities worldwide. The global Human Development Index (HDI) is projected to decline this year for the first time since 1990, effectively erasing all progress in human development made in the past 6 years.With resources diverted to tackle the pandemic, many clinical and community health services for children have reduced in capacity. A modelling study by Timothy Roberton and colleagues in The Lancet Global Health estimated that a 9·8–18·5% reduction in coverage of essential maternal and child health services and a 10% increase in child wasting prevalence would lead to 42 240 additional child deaths per month across 118 low-income and middle-income countries.
Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study

AUTHOR(S)
Timothy Robertson; Emily Carter; Victoria Chou (et al.)

Published: July 2020   Journal: The Lancet Global Health
While the COVID-19 pandemic will increase mortality due to the virus, it is also likely to increase mortality indirectly. This study estimates the additional maternal and under-5 child deaths resulting from the potential disruption of health systems and decreased access to food. Estimates show that if routine health care is disrupted and access to food is decreased (as a result of unavoidable shocks, health system collapse, or intentional choices made in responding to the pandemic), the increase in child and maternal deaths will be substantial. 
Challenges of COVID-19 in children in low- and middle-income countries

AUTHOR(S)
Heather J. Zar; Jeanette Dawa; Gilberto B. Fischer

Published: June 2020   Journal: Paediatric Respiratory Reviews
As the coronavirus pandemic extends to low and middle income countries (LMICs), there are growing concerns about the risk of coronavirus disease (COVID-19) in populations with high prevalence of comorbidities, the impact on health and economies more broadly and the capacity of existing health systems to manage the additional burden of COVID-19. The direct effects of COVID are less of a concern in children, who seem to be largely asymptomatic or to develop mild illness as occurs in high income countries; however children in LMICs constitute a high proportion of the population and may have a high prevalence of risk factors for severe lower respiratory infection such as HIV or malnutrition. Further diversion of resources from child health to address the pandemic among adults may further impact on care for children. Poor living conditions in LMICs including lack of sanitation, running water and overcrowding may facilitate transmission of SARS-CoV-2. The indirect effects of the pandemic on child health are of considerable concern, including increasing poverty levels, disrupted schooling, lack of access to school feeding schemes, reduced access to health facilities and interruptions in vaccination and other child health programs. Further challenges in LMICs include the inability to implement effective public health measures such as social distancing, hand hygiene, timely identification of infected people with self-isolation and universal use of masks. Lack of adequate personal protective equipment, especially N95 masks is a key concern for health care worker protection. While continued schooling is crucial for children in LMICs, provision of safe environments is especially challenging in overcrowded resource constrained schools. The current crisis is a harsh reminder of the global inequity in health in LMICs. The pandemic highlights key challenges to the provision of health in LMICs, but also provides opportunities to strengthen child health broadly in such settings.
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UNICEF Innocenti's Children and COVID-19 Library is a database collecting research from around the world on COVID-19 and its impacts on children and adolescents.

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Each quarterly thematic digest features the latest evidence drawn from the Children and COVID-19 Research Library on a particular topic of interest.
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COVID-19 & Children: Rapid Research Response

UNICEF Innocenti is mobilizing a rapid research response in line with UNICEF’s global response to the COVID-19 crisis. The initiatives we’ve begun will provide the broad range of evidence needed to inform our work to scale up rapid assessment, develop urgent mitigating strategies in programming and advocacy, and preparation of interventions to respond to the medium and longer-term consequences of the COVID-19 crisis. The research projects cover a rapid review of evidence, education analysis, and social and economic policies.